67 We studied nine patients with PTSD in an open-label function before and after treatment with phenytoin. Phenytoin resulted in a significant improvement in PTSD symptoms.164 Phenytoin also resulted in increases in both right hippocampal volume and right hemisphere volume.165 These findings indicate

that phenytoin has an effects on PTSD symptoms as well as brain structure in PTSD patients. We have assessed the effects of open4abel paroxetine on memory and the hippocampus in PTSD. Male and female patients with symptoms of PTSD were medication-free for at least 4 weeks before participation Inhibitors,research,lifescience,medical in the study. Twenty-eight patients were found to be eligible and started the medication phase. Of the total patient sample five patients did not finish due to noncompliance; 23 patients completed the study. Before patients started the medication phase, neuropsychological tests were administered, including the Inhibitors,research,lifescience,medical Wechsler Adult Intelligence Scale – Revised, WAISR (arithmetic, vocabulary, picture arrangement, and block design test), two subtests of the Wechsler Memory ScaleRevised.WMS-R, including logical memory (free recall of two story narratives, which represents verbal memory) and figural memory (which represents visual memory

and involved reproduction of designs Inhibitors,research,lifescience,medical after a 6-second presentation); and the verbal and visual components of the Selective Reminding Test, SRT. Paroxetine was prescribed in the first visit after the pre-treatment assessments. All patients started Inhibitors,research,lifescience,medical open-label with a dose of 10 mg daily and were titrated up to 20 mg in 4 days. Paroxetine treatment resulted in a mean 54% reduction in PTSD symptoms as measured with mean changes from AG-1478 supplier baseline on the CAPS total score (P<0.005) among study completers. Improvement was equally strong on all symptom cluster scores (Reexperiencing, Avoidance/Numbing, Hyperarousal). Treatment

also resulted in significant improvements in verbal declarative memory as measured with Inhibitors,research,lifescience,medical the WMS-R paragraph recall for delayed recall (P<0.005) and percent retention (80.2 to 91.1; P=0.003), but not immediate recall. Improvements were significant on all subscales of the Verbal Component of the SRT; including long-term recall and delayed recall. Repeated measures ANOVA with side as the repeated measure showed a main effect for treatment related Carnitine dehydrogenase to a 4.6% increase in mean hippocampal volume (1857.3 mm3 [SD 225.6] to 1906.2 mm3, [SD 243.2]) with treatment (F=8.775 df=1.36; P=0.005). Increased hippocampal volume was seen for both left (5.6%) (1807.6 mm3 [SD 255.5] to 1909.3 mm3 [SD 236.9]) and right (3.7%) (1906.9 mm3 [SD 195.8] to 1976.7 mm3 [SD 249.6]) hippocampus. There was no change in whole brain volume with treatment. Increase in hippocampal volume was significant after adding whole brain volume before and after treatment to the model.